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Elizabeth Barnett, PhD, MSPH and Joel Halverson, MA

At the time of the study, both authors were with the Office of Social Environment and Health Research, Department of Community Medicine, West Virginia University, Morgantown.

Correspondence: Requests for reprints should be sent to Elizabeth Barnett, PhD, MSPH, Office of Social Environment and Health Research, Department of Epidemiology and Biostatistics, University of Florida College of Public Health, 13201 Bruce B. Downs Blvd, MDC 56, Tampa, FL 33612-3805 (e-mail: ebarnett{at}hsc.usf.edu).

Objectives. This study analyzed coronary heart disease (CHD) mortality trends from 1985 to 1995, by race and sex, among Black and White adults 35 years and older to determine whether adverse trends were evident in any US localities.

Methods. Log-linear regression models of annual age-adjusted death rates provided a quantitative measure of local mortality trends.

Results. Increasing trends in CHD mortality were observed in 11 of 174 labor market areas for Black women, 23 of 175 areas for Black men, 10 of 394 areas for White women, and 4 of 394 areas for White men. Nationwide, adverse trends affected 1.7% of Black women, 8.0% of Black men, 1.1% of White women, and 0.3% of White men.

Conclusions. From 1985 to 1995, moderate to strong local increases in CHD mortality were observed, predominantly in the southern United States. Black men evidenced the most unfavorable trends and were 25 times as likely as White men to be part of a local population experiencing increases in coronary heart disease mortality.

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